Pascaline Priou, M.D., Marc Le Vaillant, Ph.D., Nicole Meslier, M.D., Sylvaine Chollet, M.D., Philippe Masson, M.D., Marie P. Humeau, M.D., Thierry Pigeanne, M.D., Acya Bizieux-Thaminy, M.D., Fran

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Pascaline Priou, M.D., Marc Le Vaillant, Ph.D.,
Nicole Meslier, M.D., Sylvaine Chollet, M.D.,
Philippe Masson, M.D., Marie P. Humeau, M.D.,
Thierry Pigeanne, M.D., Acya Bizieux-Thaminy,
M.D., François Goupil, M.D., Frédéric Gagnadoux,
M.D., Ph.D., The IRSR Sleep Cohort Group
Diabetes Care Volume 35 1902-1906 September,
2012
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Study Objective

• To test the hypothesis of an independent
  cross-sectional association between obstructive
  sleep apnea (OSA) severity and glycated
  hemoglobin (HbA1c) in adults without known
  diabetes

Priou P et al. Diabetes Care 2012351902-1906
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Study Design Methods

• HbA1c measured in whole-blood samples from 2,139
  patients undergoing nocturnal recording for
  suspected OSA
• Participants with self-reported diabetes, use of
  diabetes medication, or HbA1c value 6.5
  excluded from study
• Final sample size comprised 1,599 patients

Priou P et al. Diabetes Care 2012351902-1906
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Results

• Dose-response relationship observed between
  apnea-hypopnea index (AHI) and the percentage of
  patients with HbA1c gt6.0, ranging from 10.8 for
  AHI lt5 to 34.2 for AHI 50
• After adjusting for age, sex, smoking habits,
  BMI, waist circumference, cardiovascular
  morbidity, daytime sleepiness, depression,
  insomnia, sleep duration, and study site, odds
  ratios (95 CIs) for HbA1c gt6.0 were as follows
• 1 (reference) for AHI values lt5
• 1.40 (0.842.32) for values 5 to lt15
• 1.80 (1.192.72) for values 15 to lt30
• 2.02 (1.313.14) for values 30 to lt50
• 2.96 (1.585.54) for values 50
• Increasing hypoxemia during sleep was
  independently associated with the odds of HbA1c
  gt6.0

Priou P et al. Diabetes Care 2012351902-1906
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Priou P et al. Diabetes Care 2012351902-1906
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Priou P et al. Diabetes Care 2012351902-1906
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Priou P et al. Diabetes Care 2012351902-1906
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Conclusions

• In adults without known diabetes, increasing OSA
  severity independently associated with impaired
  glucose metabolism, as assessed by higher HbA1c
  values
• Impaired glucose metabolism may expose adults to
  a higher risk of diabetes and cardiovascular
  disease

Priou P et al. Diabetes Care 2012351902-1906